[PAGID] IVIG and acute renal failure

[Bodo Grimbacher]

Dear all,
I switched all the Freiburg CVID patients with kidney problems to subcut 
Ig replacement.
Just for safety considerations. I have had good results (no 
deterioration of kidney function).

Have you considered a kidney biopsy to exclude vasculitis or autoimmune 
nephritis?

Yours, Bodo

>

> I have a newly dx'd 48 y/o CVID who had pre-existing chronic renal 

> failure of unknown etiology and baseline creatinine of 3.1  We started 

> IVIG using Gamunex to avoid the high sucrose/high 

> osmolalityIVIG products.  Nevertheless, his creatinine increased to 

> 5.1 for no other apparent reason.

>

> Since I don't know the mechanism by which this occurred, I don't know 

> if it is related to the specific product or the dose.  Do people feel 

> comfortable using weekly SQ infusions in this setting?  Any other 

> thoughts?

>

> Howard 

> Howard M. Lederman, M.D., Ph.D.

> Professor of Pediatrics and Medicine

> Division of Pediatric Allergy and Immunology

> Johns Hopkins Hospital - CMSC 1102

> 600 N. Wolfe Street

> Baltimore, MD 21287-3923

> Phone:  410-955-5883

> Fax:    410-955-0229

> e-mail: Hlederm1 at jhem.jhmi.edu

>

>